NPI | 1194262279 |
---|---|
Former Name | BRANDI LEA CRUMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71010016A) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TX AP132688) |
Enumeration Date | 2017-01-26 |
Last Update Date | 2023-02-21 |